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Lester UK adaptation of the Positive Cardiometabolic Health Resource (CMH-resource) - 2014 update

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UPDATED for 2014: THE LEsTEr UK Adaptation of the positive cardiometabolic health resource:

“THE LESTER UK ADAPTATION – Positive Cardiometabolic Health Resource: an intervention framework for patients with psychosis on antipsychotic medication.” has been updated to support the implementation of the physical health CQUIN for 2014.


Download a PDF of the resource (July 2014 A5 booklet version)

Lester UK Adaptation 2014 update A5 booklet

Please note, the updated version in the original landscape format will be available shortly.


This clinical resource provides a simple framework for identifying and treating cardiovascular and type 2 diabetes risks in patients with psychosis receiving antipsychotic medication, which supports collaborative practice across professional disciplines and service settings. 

The updated 2014 version was co-produced by NHS England, NHS Improving Quality, Public Health England and the National Audit of Schizophrenia team to support the 2014 physical health CQUIN. 

The development was facilitated by the National Audit of Schizophrenia (NAS) an initiative led by the Royal College of Psychiatrists’ Centre for Quality Improvement, commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patients Outcomes Programme (NCAPOP) and involving a close collaboration with the Royal College of General Practitioners (RCGP) and the Royal College of Nursing (RCN). 

The RCGP Clinical Innovation and Research Centre worked the NAS project team to produce the 2012 version of the clinical resource for the United Kingdom (UK), adapted from work by Australian colleagues (Curtis et al, 2012). This resource provides a simple collaborative framework for identifying and treating cardiovascular and type 2 diabetes risks in any service setting. The resource was adapted for UK use initially through a consensus group led on behalf of the RCGP by Professor Helen Lester and has now been fully endorsed by the RCGP, Royal College of Psychiatrists, Royal College of Nursing, Royal College of Physicians, HQIP (NCAPOP), Rethink Mental Illness and Diabetes UK. 


Lead Authors on the UK adaptation (2014 update)


Dr David Shiers: Retired GP North Staffordshire and Clinical advisor to NAS

Dr Imran Rafi: GP in Surrey; Chair of RCGP Clinical Innovation & Research Centre; Senior Lecturer in Primary Care Education, St George’s University of London

Professor Stephen Cooper: Consultant Psychiatrist and Clinical advisor NAS

Richard Holt: Honorary Consultant Physician and Professor of Diabetes and Endocrinology, Southampton University


Lead Authors on the UK adaptation (2012 version)

Helen Lester, David Shiers, Imran Rafi, Steven Cooper, Richard Holt.


To cite:  Lester H, Shiers DE, Rafi I, Cooper SJ, Holt RIG. (2012) Positive Cardiometabolic Health Resource: an intervention framework for patients with psychosis on antipsychotic medication. Royal College of Psychiatrists. London.


Expert contributions and review comments:


Particular thanks to: Salima Adatia, Thomas Barnes, Mike Crawford, Ahmet Fuat, Roger Gadsby, Fiona Gaughran, Ellie Gordon, Kathryn Griffiths, Ian Hulatt, Kamlesh Khunti, Ian Maidment, Carol Paton, Maxine Patel, David Taylor, Jogin Thakore, Andre Tylee, David Yeomans.


Special acknowledgement:

This resource was inspired by the HETI initiative Positive Cardiometabolic Health Algorithm in Sydney, New South Wales led by Dr Jackie Curtis, Consultant Psychiatrist,  Professor Katherine Samaras, Professor of Endocrinology, and Dr Hannah Newall, Psychiatrist, to whom we offer very warm thanks for their ongoing involvement and support in developing this UK adaptation of their original work.




The Integrated Physical Health Pathway, developed by Rethink Mental Illness, is a resource that supports health professionals to coordinate physical health monitoring for people affected by mental illness and ensure information is communicated effectively between services. The resource was designed in collaboration with the Royal College of GPs, the Royal College of Nursing and the Royal College of Psychiatrists. It sets out a template for services across primary and secondary care to work together to ensure the physical health needs of people affected by mental illness are identified and addressed. Further resources and information can be found at







Download a PDF of the integrated pathway



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Bailey S, Gerada C, Lester H, Shiers D. The cardiovascular health of young people with severe mental illness: addressing an epidemic within an epidemic. The Psychiatrist 2012;36:375-378.

Gordon E, Hulatt I, Shiers D. Protecting hearts and minds. Mental Health Practice 2012;16:20-21.

Patel MX, Bishara D, Jayakumar SN, Zalewska K, Crawford MJ. Quality of prescribing for schizophrenia: Evidence from a national audit in England and Wales. European Neuropsychopharmacology 2014;24:499-509.

Shiers D, Holt R, Lester H, Rafi I. Fact file 13: Protecting the cardiometabolic health of people with severe mental illness. Diabetes Update 2012;Winter.


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